Permit (68) EXPIRED 3/ A0 5824/-----/41().-
Building Permit Application
Commercial RECEIVED ►.O►Zt)Ffi( E I. IIt)\L1
City of Tigard Receiziffe
Date/B d /� i Permit No.: 0/ .' s
OC '
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Date/B
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
JAN 2 3 2014
I i�- ,li I.) Inspection Line: 503.639.4175 Date Ready/By: runs 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OFTIGARDttt
TYPE OP ' tDING DIVISION REQUIRED DATA*.I-AND 2-FAMILY DWELG
LiN
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY oP Ce.;74 T' work indicated on this application.
0 1-and 2-family dwellingCommercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
12Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:14504 SW Fern Street New dwelling area: square feet
City/State/ZIP:Tigard,Oregon 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:PNO2 Progress Ridge AT&T Covered porch area: square feet
Cross street/directions to job site:Sw Ascension Dr/From the intersection Deck area: square feet
of SW Fern St&SW Ascension Dr heard due west 260'to the PGE Lattice tower on Other structure area: square feet
the south side of Fern St. REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:HANDY ACRES Lot no.: 16 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S104BC01200 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
f1 SCRIF'1'I I=G -wow work indicated on this application.
Construct an AT&T cell site on the existing PGE Lattice tower. The Antennaes Valuation: $$250,000.00
will be placed on the top of the tower and the equipment will be under the tower Existing building area: square feet
insde the footprint. New building area: 500 square feet
0 PROPERTY OWNER ❑ TENANTNumber of stories: N/A
Name:Steve and Callie Moon Type of construction: Cell Site
Address: 14504 SW Fern St Occupancy groups:
City/State/ZIP:Tigard Existing:
Phone:(503)579-3201 Fax:( ) New:
APPLICANT :t CONTACT PERSON
" BUILDING PERMIT FEES*
Business name:Technology Associates EC Inc. ►vh*rslev�k!
Structural plan review fee(or deposit):
Contact name:Ryan Sauvageau
FLS plan review fee(if applicable):
Address:15618 SW 72ndAve
Total fees due upon application:
City/State/ZIP:Tigard,Oregon 97224
Amount received: f / 307,.7 7
Phone:(971)678-0228 Fax::(971)245-3120 7
E-mail:ryan.sauvageau@taec.net
PHOTOVOLTAIC SOLAR PANEL SYSTEM PEES*
Commercial and residential prescriptive installation of
CONTRACTOR /o roof-top mounted Photo Voltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: Total fee due upon application: $201.60
Authorized signature: / - This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: f,(7,�,` `'jV -� ec 4 Date: * Fee methodology set by Tri-County Building Industry
}/ �1 Service Board.
1:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
t �
1111
Building Division
Accessibility: Barrier Removal Improvement Plan
l AGARI)
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $ 250,000
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 62,500
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $ 30,000
(c) An accessible route to the altered area: $ 32,000
(d) At least one accessible restroom for each sex or a single unisex
restroom: $ 0
(e) Accessible telephones: $ 0
(f) Accessible drinking fountains:and, $ 0
(g) When possible,additional accessible elements such as storage and
alarms: $ 0
TOTAL(shall equal line [2] of Valuation Computation): $ 62,500
1:ABuilding\Permits\BUP-COM PcrmitApp.doc 03/03/2011
Building Division
I I.
Plan Submittal Requirements
I I(;\R U Commercial&Multi-Family- New,Additions or Alterations
1. SITE PLAN (fully dimensional, drawn to scale) labeled with:
A. ® map& tax lot# ® project name ® site address ® suite number
® zoning ® applicant name ® phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking,including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape-ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations,plans, details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit- based on valuation of project.
4. EXTRA SET OF THE FOLLOWING:
A. Two (2) copies of site plan to include vicinity map.
B. One (1) copy of erosion control plan with details.
C. Fire Department Building Survey, and full set of architecture drawings.
l:ABuilding\Permits\BUY-COM YermitApp.doc o3/U3/2UL]
IIIBuilding Division
I al
Plan Submittal Requirement Matrix
T I( n R D Commercial&Multi-Family-New,Additions or Alterations
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 3
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 3
Fire Protection System 3
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,Washington
County, and Tualatin Valley Fire & Rescue), if applicable.
l:ABuilding\Permits\RIP-COM Permit.App.doc (13/113/201 1
Building Permit Number: c t c aD/ L'O0o/5
• ' Building Permit Review
Commercial Project—No Associated Land Use Case
TIGARI)
Site Address: .
` `) ri -7 fA- L
❑Verify site address is valid. 4
Project Name : //\'L7-14' �:i s /2 Au .41
Planning Review_ -
1 )-
Proposal: .c i, i 1 @ ti(hp*d.,, 4,1 C.x;, '� ) � / -
L Zoning: k-`7
r
❑ Permitted Use EJ Yes ❑ No ❑ Spec Space
❑ Land Use Required ❑ Yes Er No j
Notes: ,/ c r G`< ` .44 I'`,(/ 44;71- '‘.r. "D1474.4164".‘
% i t
Approved by: •,r`V_ Date: i -,-. -i 7
Revisions (after Building Submittal only) Reviewer Date
Revision 1 Approved ❑ Not Approved ❑
Revision 2 Approved ❑ Not Approved ❑
Revision 3 Approved ❑ Not Approved ❑
Building Permit Submittal
Original Plan Submittal: Date: I l A 31)'/ B
Site Plans: # 3
Building Plans: # 3
Create Case Record#: 'Enter case# above for Building Permit Number. 0/
Workflow Routing: (Planning ❑ Engineering ❑ Permit Coordinator Id Building
Workflow Sign-off: Sign-off for Planning staff,including notes from planning review(page 1)
Route Application Documents: ❑ Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Er Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Reviewed By: Date:
Notes:
I:\Building\Forms\BIdgPermitRvw_COM NoLandUse_123013.docx
114 111 COLLOCATION
VJOI
- SupplementalQuestionnaire 4
Ques to e� 2p�
TIGARD City of Tigard, 13125 SW Hall Blvd., Tigard, OK 97223 �PN 23
Phone: 503.718.2421 Fax: 503.598.1960 '`ellCCI ‘
G...tmtaRT 1 Nis 0111)1.
IF YOU ARE APPLYING FOR A PERMIT TO COLLOCATE ANMIWNNAS,
PLEASE COMPLETE THE INFORMATION BELOW.
',4--
Name of Provider: !-'i /t'
t �
Property Address Location of Collocation: / -,,�c ` • (,4/ ,,+'k
Zone: / ,:
Collocating antennas on: ❑ Existing tower Existing non-tower structure
Is this a new provider? Yes n No
Ifyes, list other providers currently collocating on same tower or structure, if any:
t
i ib7 e.
If no, indicate the previous approval(SDA,MMD or B UP#): t4/1/11-
,,,,i
Height
1JJ ft-
Height of antenna(s): 6 ft.
Color of antenna(s) and accommodating equipment (i.e. dishes):
Color of existing tower or structure: 1;--7,51/1, ::uz .
s"
Will new accessory equipment be installed? `'Yes I I No
Ifyes,please answer the following:
Location of accessory equipment: ❑ Within fenced area previously approved
YWithin existing structure
❑ Other location (Please describe below.)
Will landscaping be removed to accommodate the access6y equipment?
n Yes (Please describe below.) `- No
4
Applicant's Signature: � 1 ' l'n'
/141).� '``t�P"" Date: r .* i
Name Printed: ,''`J
0,
Name )144; ,,6.,;l tett Phone:
OK to isla polnit n Do not issue permit. Refer to planner.
Plannint Staff Si' ature Date
I:\CURPLN\Masters\CollocateAntennas.doc